Assessing Swallowing Function is Important Upon Admission to Community-Based Integrated Care Wards. A Retrospective...

This study aimed to evaluate patients' swallowing ability at the time of admission to community-based integrated care wards and to assess the importance of this evaluation.

77 older adult patients admitted to the wards between April 2023 and March 2024 participated in the study. Within 48 h of admission, an original screening tool and meal rounds were collaboratively administered by a multidisciplinary team to assess patients' oral and pharyngeal function and their mode of nutritional intake. Dysphagia diets were classified according to the Dysphagia Diet Classification 2021 and compared with the International Dysphagia Diet Standardization Initiative. Oral and pharyngeal function were assessed using the Food Intake LEVEL Scale (FILS) and standardized meal rounds. Fiberoptic endoscopic evaluation of swallowing was performed when necessary. Associations between changes in food intake routes and discharge destinations were analyzed using the chi-squared test, while changes in FILS scores were evaluated using the Wilcoxon signed-rank test.

Aspiration pneumonia and cerebrovascular disorders were the most common illnesses. Many patients were safely transitioned from total or peripheral parenteral nutrition to oral intake, accompanied by significant improvements in FILS scores. The findings demonstrate the effectiveness of assessing swallowing ability and determining appropriate feeding routes in community-based integrated care wards.

This study could contribute to better establishing appropriate feeding methods and managing patient nutrition during hospitalization. By using multidisciplinary shared swallowing-assessment tools, safe transition to oral intake can be promoted without necessarily performing detailed examinations.